Provider Demographics
NPI:1922314137
Name:TOREN, LAURA E (OD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:E
Last Name:TOREN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:E
Other - Last Name:GENGELBACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:355 N PETERS AVE
Mailing Address - Street 2:
Mailing Address - City:FOND DU LAC
Mailing Address - State:WI
Mailing Address - Zip Code:54935-8258
Mailing Address - Country:US
Mailing Address - Phone:920-922-7121
Mailing Address - Fax:
Practice Address - Street 1:11005 W 60TH ST STE 210
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66203-2789
Practice Address - Country:US
Practice Address - Phone:913-631-7700
Practice Address - Fax:913-631-8080
Is Sole Proprietor?:No
Enumeration Date:2010-08-25
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2016152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management